Billing for Xmatched platelets or HLA matched platelets

[conwaysbb]

With the use of ISBT 128 coded platelet products there is not a code for x-matched platelets or HLA matched platelets. With Codabar products we were able to charge for a HLA matched platelet pheresis product with P code P9052.

The information I have from ICCBA is as follows:

"The HLA phenotype of an apheresis platelets is similar to CMV—it is encoded into a special testing data structure (Data Structure 014).

A platelet crossmatch is not encoded on the affixed, since like a RBC crossmatch, it is a factor associated with the patient more than the unit. This information would probably be included on a tie tag (or a sticker above the affixed label on the bag)."

How are hospitals charging/billing for these 2 products.

Thanking you in advance

[SMW]

Why would ISBT128 labeled products be charged differently than Codabar labeled products? The "P-code" is a billing code and is not specific to Codabar or ISBT128 labeled products, e.g., there is not a unique Codabar product code for a crossmatched Platelet product or an HLA-matched Platelet product vs. a non-matched Platelet product. They have the same Codabar product code with additional "selection attributes" associated with the product and as ICCBBA has referenced similar to CMV sero-negative products. There are different "P-codes" for CMV-negative products vs. products not tested for CMV but the Codabar (or ISBT128) product codes are the same.

[bbbirder]

I must agree with SMW, the CMS "P" codes don't always match FDA approved product codes. When we have HLA matched PLTs, we manually adjust the billing. We are lucky that this is rare for us.

I don't know what your LIS system is, but you may be able to create charge rules based on unit/patient markers.

Linda Frederick